Ovulation and The Menstrual Cycle
A few unfamiliar terms
The Basic Infertile Pattern
This is an unchanging mucus pattern reflecting a basic low level of oestrogen. It happens early in the cycle for most women with 'normal' cycles and is evident for a long period of time while breastfeeding, during peri-menopause and in women who do not ovulate regularly.
The fertile pattern is a changing mucus pattern, reflecting a steadily rising level of oestrogen as the woman comes closer and closer to ovulation eg. a women may experience the basic infertile pattern as dryness and notice thick, white, gluggy infertile type mucus. After a few days she may notice that the mucus changes slightly and becomes thinner. For this woman, the basic infertile pattern is a dry feeling with thick, white, gluggy mucus. Any deviation from this should be seen as potentially fertile mucus.
The point of change
This is the day that the mucus changes from the basic infertile pattern.
The peak mucus day
This is the last day that any fertile mucus is noticed.
Fertility signs and the phases of the menstrual cycle
The pre-ovulatory phase
The pre-ovulatory signs of the menstrual cycle that most women can identify are:
- The beginning of the pre-ovulatory phase. This is the first day of the period which also signifies the first day of a new cycle.
- Days which show no sign of cervical mucus- These are the days following the period before the cervical mucus symptom begins
- The beginning and development of the cervical mucus symptom. Read on to learn about this.
The ovulatory phase
Most women will notice:
- Fertile type cervical mucus
- Changes at the cervix
Some women may also notice:
- Increased libido- this can make abstinence particularly difficult if you are trying to avoid pregnancy!
- Ovarian pain which can be on one or both sides
- Swelling or a feeling of fullness at the vulva
- Bleeding or spotting
- Mood changes- teariness, depression, anxiety, anger
The post ovulatory phase
Most women will notice:
- The end of the fertile mucus symptom
- A higher basal body temperature
Menstruation
This usually indicates that a pregnancy has not occurred in the previous cycle. Bleeding begins on day 1 of the cycle and continues for a number of days varying from 3-7 in the majority of women.
You can't rely on a period as sign that ovulation has occurred or as an absence of fertility since bleeding occurs as a result of hormonal triggers with or without ovulation. This often happens to women with poly cystic ovarian syndrome. The only indicator that ovulation has occurred is the temperature shift. If you don't see a temperature shift you should assume that you are still in the pre-ovulatory phase and that you are potentially fertile.
Cervical mucus changes
When monitoring the cervical mucus symptom, it is necessary to be aware of the sensation that you feel at the vulva and the cervical mucus that you can see.
Sensation
Some words to describe these different feelings are:
- Dry
- Wet
- Slippery
- Damp
Fertile mucus can often be felt like the sensation you feel as you notice your period has started.
Appearance
This is best monitored by looking at the toilet paper before and after urinating each time you go to the toilet. Fertile mucus will often look clear and be quite stretchy, it is often described as raw egg white. Infertile mucus may have a thicker appearance and can appear absent, gluggy or claggy. It is often white or yellowish in colour.
It is important to note that not all women experience the fertile mucus symptom. It is common after coming off the pill, breastfeeding or approaching menopause to have unreliable mucus symptoms. There are also several gynaecological disorders that can make mucus symptoms quite difficult to interpret. For some women it is just normal for them to have little mucus and so is difficult to see.
Some words to describe mucus appearance:
- Stretchy
- Clear
- White
- Yellow
- Gluggy
- Flakey
Things that interfere with mucus observation
Intercourse with or without ejaculation
- You can't tell the difference between seminal fluid, lubricating vaginal mucus and fertile cervical mucus.
Medications
There are certain medications that can change cervical mucus, these include:
- Any antihistamine: these can dry up mucus
- Bisolven: rather than drying up mucus, it liquefies it
- Some antidepressants
- Herbal medicines, golden seal and horseradish; these are commonly used as cold and flu remedies
- High doses of the acidic form of vitamin C ascorbic acid
- Prescription antibiotics
These drugs will also reduce fertility because they interfere with healthy cervical mucus.
Health
There are some health conditions that can affect the mucus pattern also, making it quite difficult to use mucus as a fertility sign. These conditions may also affect your chances of achieving a pregnancy.
These include:
- Poly-cystic ovarian syndrome
- Menopause
- Coming off the pill
- Breastfeeding
- Infections such as thrush, vaginitis
- Nutrient deficiencies especially zinc, calcium, magnesium, vitamin A and Iron
What if I have trouble identifying my mucus patterns?
You can use the cervix changes as a double check for approaching fertility or you can go searching for mucus.
Changes at the cervix
Around the time of ovulation the cervix moves higher up in the vagina, becomes more upright, feels soft to touch, it can open a little and it feels very moist from cervical mucus.
Pre and post ovulatory the cervix sits low in the vagina, feels firm, is closed and is tilted.
These signs are quite pronounced and can be a very good indicator for predicting ovulation, although it can take several months of daily examination to get to know these signs well.
Some women also find that the cervix goes higher in the vagina, feels open and points down just before the period begins. You will know if this is a sign of an approaching period or approaching fertility if you have recorded a temperature shift earlier in the cycle.
Self examination of the cervix
This is easiest to carry out sitting on the toilet or standing with one leg raised and resting on the bath, a chair or the bed. Squatting has also been recommended as a good position.
It is really important to always use the same position to examine the cervix. Many women find that it is easiest to check while on the toilet either first thing in the morning or right before bed.
It is a simple matter of inserting a finger into the vagina and feeling for the position, the tilt and whether the opening feels soft and open or hard and closed tight. With a bit of practice most women find it pretty easy. Need help?
Searching for mucus
Some women find it helpful to insert a finger and try to scoop cervical mucus out to examine it. Most women won't need to do this but if you have very little mucus it is an option. If you still have trouble finding mucus another option is to give the cervix a little squeeze. This will cause the cervix to discharge a little mucus and allow you to asses the colour, stretchiness and consistency.
This is not recommended by Billings or Natural Family Planning teachers as there is some concern that the normal moist environment of the vagina can be confused for mucus. I believe that once you've had a bit of practice and observed your body over a couple of cycles you'll know the difference. If you do find you have trouble telling the difference you can test to see if it is water soluble or not. Get yourself a glass of water and collect some mucus on your finger. If it is cervical mucus it will form a blob and sink to the bottom, if it is a vaginal secretion it will dissolve.
Basal body temperature
This is the body temperature of the body when it is at rest. During a women's menstrual cycle, the basal body temperature shows two distinct phases. This is known as a biphasic pattern. It shows a lower temperature before ovulation and a slightly higher temperature after ovulation.
A sustained rise in BBT tells you that you have ovulated. Once ovulation has occurred, fertilisation can only take place within 12-24 hours before the egg is no longer viable.
Getting an accurate reading
In order too get accurate temperature readings that are easy to interpret, readings must be taken:
Immediately on waking before getting out of bed - This means before getting up to children, going to the toilet, eating, drinking or if your lucky enough; morning sex. If any of these things are necessary before taking your temperature, an accurate temperature reading can be taken after another 1 hour of sleep.
At approximately the same time every day - Sleeping in a few hours may cause a higher temperature reading.
Vaginally - This is the most accurate way to take a BBT temperature and will give a more stable reading. Under arm readings are close to useless for charting. Oral temperatures can be used but are not as accurate as vaginal.
Temperatures can be taken from day 1 or if you prefer you can start after the period has finished. If you tend to have short cycles it is important to take the temperature from day 1 in order to get a good baseline reading.
Temperature readings can be affected by:
- Sleeping in
- Eating a heavy protein meal the night before
- Drinking too much alcohol the night before
- Illness
If any of these things happen, be sure to write it on your chart, you may choose to ignore the reading if it doesn't seem to fit.
Ovulation mythconceptions
A normal cycle is 28 days in length
Very few women have a text book 28 day cycle, or even cycles that never vary from a particular number of days. There are always variations in the cycle length as well as key events within the cycle such as ovulation. This is why the rhythm method is very unreliable for many women.
Ovulation always occurs in the middle of the cycle.
The time from ovulation until the start of the next period is fairly constant in every women and only varies by 1 or 2 days from cycle to cycle.
The time between the period and ovulation is not constant. This can vary greatly cycle to cycle. This is known as the pre-ovulatory phase and it is this time which causes irregularity in cycle length. Variations in this phase are common in women who have poly cystic ovarian syndrome or hormonal irregularies.
You can ovulate more than once in a cycle.
There was a rather damaging article spreading this myth last year that was later retracted. Of course, less people know of the retraction than the original article.
The article spoke of research which had been misinterpreted by the author. Good sound research has shown that multiple ovulation can occur but that it always happens 10-16 days before the period. If more than one ovulation is going to take place they will happen at the same time or within 12 hours of each other.
Questions? Do you need clarification?
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more:
- Achieving Pregnancy Using Fertility Awareness
- Preconception Dietary Guidelines
- Pre-conception nutritional supplementation recommendations